Lawmakers to CMS: Create an ICD-10 contingency plan

An ICD-10 contingency plan is needed in case the Centers for Medicare & Medicaid Services (CMS) is unable to process the new codes, members of Congress said in a letter to Acting Administrator Andy Slavitt.

Thirteen legislators--led by Reps. Kevin Brady (R-Texas), Sam Johnson (R-Texas) and Tom Price (R-Ga.) and 10 others--also made the following requests:

• Indicate whether claims need to have the ICD-10 code with the highest level of specificity on Oct. 1 or if a less granular code would be OK
• Create a description for the public of how the new codes will be used for incentive payment program for reporting on quality of care and how they will be incorporated into anti-fraud efforts
• Offer end-to-end testing to providers beyond the 2,500 currently eligible for the testing, particularly a focus on smaller providers, who have struggled the most with the transition.
• Inform providers about resources available to prevent claims processing disruption in the event they can't submit ICD-10 codes.

"Providers need to be aware that fallback options are available if they experience problems with their billing systems," the letter reads. "CMS needs to use the tools at its disposal to ensure a smooth transition to the new coding system. Using those tools in a transparent manned with help to avoid provider cash flow problems that could lend to patient care disruptions."

Read the letter.